Zhang Hairui, Zhao Zhiyao, Zhou Fangzheng, Liu Xiaoning
Orthopaedic Medical Center, Second Hospital of Jilin University, Changchun, People's Republic of China.
Sci Rep. 2025 Apr 4;15(1):11538. doi: 10.1038/s41598-025-95649-9.
The intra-articular corticosteroid injection (IACI) and arthroscopic partial meniscectomy (APM) are crucial treatment options for meniscus tears and are widely used in clinical practice. To determine whether there are differences in the progression of osteoarthritis (OA) after APM and IACI treatments for degenerative meniscal tears, and to identify the influencing factors. We finally collected the minimum joint space width (JSW), WOMAC score, and KOOS score of 189 patients after 4 years of follow-up. The mixed effects model and general estimating equation were used to analyze the differences in the progression of knee osteoarthritis and the factors affecting the progression of knee osteoarthritis in patients with degenerative meniscus tears who received different treatments. Over a 48-month follow-up period, all three groups showed a decreasing trend in knee JSW, with the IACI group having the fastest JSW decline rate at -0.020 mm/month (95% CI: -0.027 to -0.013, p < 0.01). There was no statistically significant difference in the JSW decline rate among the three groups. The WOMAC total scores for both the IACI and APM groups showed an improving trend, at -0.123/month (95% CI: -0.211 to -0.036, p < 0.01) and - 0.115/month (95% CI: -0.201 to -0.028, p < 0.01) respectively, with no statistical difference between the two groups. BMI was also a significant factor affecting postoperative JSW (regression coefficients: -0.012, 95% CI: -0.022 to 0.001, p = 0.03) and WOMAC total scores (regression coefficients: 0.189, 95% CI: 0.008 to 0.370, p = 0.04). Compared to single IACI, multiple IACI treatments resulted in faster JSW decline (B: 0.430, 95% CI: 1.012 to 2.336, p = 0.04). Patients with degenerative meniscal tears who undergo either IACI or APM treatment exhibit more pronounced progression of knee osteoarthritis compared to those in the non-treatment group. This form of deterioration is mainly driven by BMI.
关节内注射皮质类固醇（IACI）和关节镜下半月板部分切除术（APM）是半月板撕裂的关键治疗选择，在临床实践中广泛应用。为了确定APM和IACI治疗退行性半月板撕裂后骨关节炎（OA）进展是否存在差异，并确定影响因素。我们最终收集了189例患者随访4年后的最小关节间隙宽度（JSW）、WOMAC评分和KOOS评分。采用混合效应模型和广义估计方程分析接受不同治疗的退行性半月板撕裂患者膝关节骨关节炎进展的差异以及影响膝关节骨关节炎进展的因素。在48个月的随访期内，所有三组患者的膝关节JSW均呈下降趋势，IACI组JSW下降速度最快，为-0.020mm/月（95%CI：-0.027至-0.013，p<0.01）。三组之间的JSW下降率无统计学显著差异。IACI组和APM组的WOMAC总分均呈改善趋势，分别为-0.123/月（95%CI：-0.211至-0.036，p<0.01）和-0.115/月（95%CI：-0.201至-0.028，p<0.01），两组之间无统计学差异。BMI也是影响术后JSW（回归系数：-0.012，95%CI：-0.022至0.001，p=0.03）和WOMAC总分（回归系数：0.189，95%CI：0.008至0.370，p=0.04）的重要因素。与单次IACI相比，多次IACI治疗导致JSW下降更快（B：0.430，95%CI：1.012至2.336，p=0.04）。与未治疗组相比，接受IACI或APM治疗的退行性半月板撕裂患者膝关节骨关节炎进展更为明显。这种恶化形式主要由BMI驱动。
